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正颌外科中下颌骨的移动——一项多中心分析

Moving the mandible in orthognathic surgery - A multicenter analysis.

作者信息

Thiele Oliver C, Kreppel Matthias, Bittermann Gido, Bonitz Lars, Desmedt Maria, Dittes Carsten, Dörre Annegret, Dunsche Anton, Eckert Alexander W, Ehrenfeld Michael, Fleiner Bernd, Frerich Bernhard, Gaggl Alexander, Gerressen Marcus, Gmelin Leonore, Hammacher Andreas, Haßfeld Stefan, Heiland Max, Hemprich Alexander, Hidding Johannes, Hölzle Frank, Howaldt Hans-Peter, Iizuka Tateyuki, Kater Wolfgang, Klein Cornelius, Klein Martin, Köhnke Robert H, Kolk Andreas, Kübler Alexander C, Kübler Norbert R, Kunkel Martin, Kuttenberger Johannes J, Kreusch Thomas, Landes Constantin, Lehner Bernhard, Mischkowski Robert A, Mokros Steffen, Neff Andreas, Nkenke Emeka, Palm Frank, Paulus Gerhard W, Piesold Jörn U, Rasse Michael, Rodemer Herbert, Rothamel Daniel, Rustemeyer Jan, Sader Robert, Scheer Martin, Scheffler Birgit, Schippers Christian, Schliephake Henning, Schmelzeisen Rainer, Schramm Alexander, Spitzer Wolfgang J, Stoll Christian, Terheyden Hendrik, Weingart Dieter, Wiltfang Jörg, Wolff Klaus D, Ziegler Christoph M, Zöller Joachim E

机构信息

Department of Oral, Maxillofacial and Facial Plastic Surgery (Head: Prof. R. A. Mischkowski), Ludwigshafen Hospital, Germany.

Department of Craniomaxillofacial and Plastic Surgery (Head: Prof. J.E. Zöller), University of Cologne, Germany.

出版信息

J Craniomaxillofac Surg. 2016 May;44(5):579-83. doi: 10.1016/j.jcms.2016.01.024. Epub 2016 Feb 3.

Abstract

Orthognathic surgery has always been a classical focus of maxillofacial surgery. Since more than 100 years, various surgical techniques for mandibular repositioning have been developed and clinically tested. Since the establishment of plate and screw osteosynthesis, orthognathic surgery became more stable and safe. Nowadays, different surgical methods for mobilising the mandible are existing. This international multicenter analysis (n = 51 hospitals) is providing first evidence based data for the current use of different surgical methods. The dominating techniques were Obwegeser/dal Pont (61%) followed by Hunsuck/Epker (37%) and Perthes/Schlössmann (29%). The main osteosynthesis materials were plates (82%), bicortical screws (23.5%), or a combination of both (5.9%). 47% of all centers reported to use several surgical methods at the same time, depending on the anatomical problem and the surgeon's preference. This shows that different surgical methods seem to work as comparable, safe, and reliable procedures in everydays clinical practise. On this basis, further prospective studies could evaluate possible advantages for our patients.

摘要

正颌外科一直是颌面外科的经典重点领域。100多年来,已开发出多种下颌骨重新定位的手术技术并进行了临床测试。自钢板和螺钉骨固定术确立以来,正颌外科变得更加稳定和安全。如今,存在不同的下颌骨移动手术方法。这项国际多中心分析(涉及51家医院)为当前不同手术方法的使用提供了首个基于证据的数据。主要技术是Obwegeser/dal Pont法(61%),其次是Hunsuck/Epker法(37%)和Perthes/Schlössmann法(29%)。主要的骨固定材料是钢板(82%)、双皮质螺钉(23.5%)或两者结合(5.9%)。所有中心中有47%报告称会根据解剖问题和外科医生的偏好同时使用多种手术方法。这表明在日常临床实践中,不同的手术方法似乎具有相似的效果,都是安全可靠的程序。在此基础上,进一步的前瞻性研究可以评估对我们患者可能存在的优势。

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